非金属桩核冠系统在磨牙大面积缺损修复中的应用

目的 评价磨牙大面积牙体缺损采用纤维桩及全瓷冠修复的短期临床效果.方法 28例患者,共33颗磨牙残冠根采用纤维桩及全瓷冠修复.于修复体黏固后1周、1个月及6 ～ 24个月复查,评价修复体完整性,边缘适合度,牙周组织健康状况及根尖周健康状况.结果 93.9%的修复体保持完整.有2颗修复体发生崩瓷或折裂,为咬硬物所致.所有修复体边缘适合性良好,色泽稳定,牙龈状况良好.纤维桩及树脂核无松动、折裂、缝隙等.X线片未见根尖异常,未见根折或桩折.结论 在严格掌握适应证的条件下,将纤维桩及全瓷冠用于磨牙残根残冠修复能够取得良好的近期临床效果.     

可塑性玻璃纤维桩修复牙本质肩领不完整的前牙牙体缺损观察

目的 观察可塑性玻璃纤维桩对牙本质肩领不完整前牙牙体缺损的修复效果,以期为临床提供参考.方法 对38例患者的28颗牙本质肩领完整和23颗肩领不完整的患牙制作桩核-金瓷冠,牙本质肩领完整组包括13件金属桩核和15件可塑性纤维桩-树脂核,牙本质肩领不完整组包括11颗金属桩核和12颗可塑性纤维桩-树脂核.分别于修复后0.5、1年复查,观察修复体和基牙情况并拍摄根尖X线片.结果 27例患者41件修复体完成0.5年复查,14例患者20件修复体完成1年复查,3例患者(3件修复体)失访.复查结束时所有修复体边缘完整、无冠及桩核折断、无松动,患牙无冠折或根折.结论 可塑性玻璃纤维桩修复不完整的前牙牙体缺损,短期内均可取得良好的临床效果.     

纤维桩树脂核在修复前牙残根残冠的应用观察

目的观察玻璃纤维桩树脂核修复前牙残根残冠的临床效果。方法选择35例患者的47颗已行完善根管治疗的上下前牙残根、残冠,采用玻璃纤维桩及树脂制作桩核,金合金烤瓷冠或全瓷冠修复,随访观察。结果随访1-5年,47颗修复体均无松动脱落,无根折,无龈缘变色。结论玻璃纤维桩树脂核修复前牙残根残冠的短期临床效果稳定,但仍需长期观察。     

前牙IPS e.max全瓷冠对牙龈影响的临床观察

目的 评价前牙IPS e.max全瓷冠对牙龈的影响.方法 镍铬合金烤瓷全冠修复后牙龈发炎、红肿的患者42例102颗前牙,拆除烤瓷冠,经牙周和根管治疗、桩核修复牙体缺损后,行IPS e.max全瓷冠修复,随访6～12个月,观察修复体颜色、牙龈状况及边缘密合性.结果 38例患者对修复体颜色满意,4例患者认为修复体颜色可接受;88个全瓷冠牙龈健康状况良好,14个全瓷冠牙龈健康状况可接受;102个全瓷冠边缘密合性好.结论 前牙镍铬合金烤瓷全冠修复失败后,可选用IPS e.max全瓷冠修复以改善修复体与组织的生物相容性.     

两种纤维桩短期修复效果的临床观察

目的 观察两种玻璃纤维桩修复系统修复牙齿缺损的短期临床疗效。方法 选择北京宣武中医医院口腔科门诊和北京大学口腔医院特诊科因牙体缺损进行桩核冠修复的符合纳入标准的120例患者,经知情同意后,随机分2组,每组 60例,分别采用 Tenax Fiber White纤维桩与国产 OUYA FIBER纤维桩修复系统修复,修复后 1周与 3个月复诊,检查纤维桩修复的临床效果。结果 Tenax Fiber White纤维桩与OUYA FIBER纤维桩修复1周后,检查纤维桩修复体的总体情况、边缘密合性、边缘着色情况,两组满意率均达到 98%以上;3个月后复查,通过 X线片检查纤维桩的总体情况和基牙情况,以及咀嚼功能恢复情况,两组满意率均达到 96%以上;2组间比较差异无统计学意义（P>0.05）。结论 OUYA FIBER纤维桩与Tenax Fiber White纤维桩在3个月的观察期间的总体疗效相当,值得推广应用,但仍需对其疗效进行长期的临床观察。     

玻璃纤维桩在前牙残根残冠修复中的临床应用

目的:探讨玻璃纤维桩在前牙残根残冠修复中的临床应用效果。方法:将154颗经过完善根管治疗的前牙随机分为两组,A组77例植入玻璃纤维桩后行烤瓷冠修复,B组77例植入金属铸造桩核行烤瓷冠修复,进行0.5～2年随访。结果:A组76例修复体及基牙完好,成功率为98.70%;B组70例修复体及基牙完好,修复成功率90.90%。结论:运用玻璃纤维桩进行前牙残根残冠修复,具有操作方便,简捷及良好的生物相容性,能有效防止根折和牙周病变。     

玻璃纤维桩用于前牙残根、残冠修复的临床观察

目的研究玻璃纤维桩在前牙残根、残冠修复中的临床应用效果。方法临床选择69例患者,共136颗患牙,均为上下前牙残根或残冠,备牙后龈上剩余牙体组织小于3 mm的10颗,备牙后龈上剩余牙体组织3 mm以上者126颗,经过完善的根管治疗,采用玻璃纤维桩制作桩核,Procera氧化锆全冠修复。对修复效果进行随访评价。结果随访12~48个月,未发现根折;131个修复体边缘密合,未见松动,无脱落无继发龋损,牙周健康;有4颗牙发生纤维桩核松动脱落,有1颗纤维桩折断。成功率为96.32%。所有患者对修复体美学效果均感满意。结论对前牙残根残冠使用玻璃纤维桩Procera氧化锆全冠修复美学效果良好,不易造成根折,可以获得较高的成功率,达到满意的修复效果。     

高强度玻璃纤维复合树脂桩在前牙重度牙体缺损修复中的疗效

采用高强度玻璃纤维复合树脂桩核加氧化铝全瓷冠修复前牙牙冠大部缺损共41 例62 个牙,通过0.6～2.0 年的临床观察,除2例残根修复体桩在修复后半年脱落外,其余修复体无桩折断或脱落,无牙龈着色,患者满意度良好.     

玻璃纤维桩修复后牙残冠、残根的效果评价

目的:探讨玻璃纤维桩核与金属烤瓷全冠修复后牙残冠、残根的临床效果.方法:选取100例(18～60岁)后牙残冠、残根患者,共计195颗患牙.经过完善的根管治疗后随机分为2组,实验组50例患者共95颗患牙,植入玻璃纤维桩核;对照组50例患者共100颗患牙,用金属铸造桩核修复.2组患者均用金属烤瓷全冠恢复牙体外形.观察2组患者的修复体形态、功能和成功率,并用SPSS13.0软件包对2组修复体的成功率进行X2检验.结果:随访36个月,实验组共90颗牙咀嚼功能良好,无不适主诉,修复体牢同,牙龈及根尖无明显炎症,占总数的94.74%,而对照组100颗牙获得85.00%的成功率,2组差异有显著性意义(P＜0.05).结论:玻璃纤维桩核可以作为理想的后牙残冠、残根桩核修复材料.     

计算机辅助设计与制作氧化锆桩核在前牙修复中的应用

目的评价计算机辅助设计与制作(computer-aided design and manufacturing,CAD/CAM)氧化锆桩核在前牙残根、残冠修复中的应用效果。方法收集前牙大面积缺损患者68例共75颗患牙,CAD/CAM氧化锆桩核和全瓷冠修复,随访6～24个月,从修复体的稳定性、美观效果及牙周健康状况3个方面进行评价。结果 75颗全瓷冠修复体,2颗桩核与根部之间出现松动,牙冠与桩核之间不松动;1颗出现冠松动,桩核与根部无松动。X线片未见根尖周病变,也未出现根折、桩折。修复体与邻牙及对侧、对颌同名天然牙的电脑比色数值(Shade值)差值为0的占41颗,差值为1～2的占34颗,差值为3及以上的为0颗。修复体外形美观,无边缘着色,牙龈形态与颜色正常。6～24个月累计成功率为96%(72/75)。结论 CAD/CAM氧化锆桩核应用于前牙修复近期效果满意。     

纤维桩主辅桩在喇叭口状根管桩核修复中的临床效果观察

目的：评价纤维桩主辅桩十全瓷冠修复喇叭口状残冠残根的临床效果。方法：选择28例患者37颗需修复的喇叭口状单根管残冠残根为研究对象。患牙经根管治疗后行纤维桩主辅桩＋复合树脂核及全瓷冠修复,于修复完成后随访18-26个月,评价修复体完整性、边缘适合性、牙周及根尖周组织健康状况等。结果：37个修复体完整,成功率100％;冠边缘适合性好达91．89％,可接受8．11％;色泽匹配好达75．68％;牙龈状况好达83．79％;纤维桩及树脂核无松动、折裂、缝隙等;根尖未见异常,无根折发生。结论：纤维桩主辅桩系统临床修复喇叭口状残冠残根取得良好的临床效果,可作为保存此类残冠残根简便有效的修复方式。     

Tenax玻璃纤维桩修复前牙残冠残根的临床疗效观察

目的 探讨玻璃纤维桩树脂核加全瓷冠修复前牙残冠残根的临床疗效。方法 选择86例120颗前牙残冠残根,随机分为治疗组43例64颗和对照组43例56颗,治疗组患者采用玻璃纤维桩树脂核加全瓷冠修复,对照组患者采用铸造金属桩核加镍铬烤瓷冠修复。采用美国加州牙科协会的烤瓷冠修复临床标准进行疗效评价。结果 治疗组成功率为96.8%,对照组成功率为83.9%。结论 玻璃纤维桩和全瓷冠是修复前牙残冠残根的理想材料。     

两种材料桩冠修复前牙残冠和残根的临床效果观察

目的 观察铸造金合金核桩冠和玻璃纤维核桩冠修复前牙残冠残根的临床效果。方法 选取72例(18~52岁)前牙残冠残根患者,共计120颗患牙,经过完善的根管治疗后随机分为2组:A组60颗患牙,使用铸造金合金核桩冠;B组60颗患牙,使用玻璃纤维核桩冠;同时每一组又分为有牙本质肩领组和无牙本质肩领组。全部患牙均用贵金属烤瓷全冠恢复牙体外形。观察2组患者的修复成功率。结果 随访24个月后,铸造金合金核桩冠组和玻璃纤维核桩冠组修复成功率相似,但在有牙本质肩领和无牙本质肩领时铸造金合金核桩冠组和玻璃纤维核桩冠组修复成功率相差较大。结论 牙体组织残留量及所选核桩材料与修复成功率密切相关。?     

Analysis of dentinal stress distribution of maxillary central incisors subjected to various post-and-core applications

This study evaluated the stress distribution on an endodontically treated maxillary central incisor restored with different post-and-core systems by using a three-dimensional finite element analysis model. Seven three-dimensional finite element models were created. Each model contained cortical bone, cancelous bone, periodontal ligament, 3 mm apical root canal filling, post-and-core and all-ceramic crowns. Two different pre-fabricated zirconia ceramic post systems, a glass fiber-reinforced post system and a titanium post system were modeled. As a control, an all-ceramic crown on an endodontically treated maxillary central incisor without a post-and-core was modeled. Each model received a 45 degrees oblique occlusal load at a constant intensity of 100 N. In each model, the ratio of Von Mises stress distribution was compared. The greatest stresses were observed in the coronal third of the roots on facial surfaces. The ratio of Von Mises stress distribution in dentin for the zirconia ceramic post (CosmoPost) and ceramic core (Cosmo Ingot), zirconia ceramic post (CosmoPost) and composite core (Tetric Ceram), glass fiber-reinforced post (FRC Postec) and composite core (Tetric Ceram), titanium post (Er post) and composite core (Tetric Ceram), zirconia ceramic post (Cerapost) and ceramic core (Cosmo Ingot), zirconia ceramic post (Cerapost) and composite core (Tetric Ceram) and the control group were 0.886, 0.889, 0.988, 0.924, 0.889, 0.893 and 1, respectively. The stress concentrations in dentin created by two different zirconia ceramic post systems were nearly the same. The zirconia ceramic post systems created slightly less stress concentration in dentin than the glass fiber-reinforced and titanium posts.     

CAD/CAM一体化氧化锆桩核的临床评价

目的:观察CAD/CAM一体化氧化锆桩核在修复前牙残冠、残根中的临床效果。方法:本研究对45颗残冠、残根使用自凝塑料在口中制作桩核模型,应用CAD/CAM技术切削出一体化氧化锆桩核,运用一体化氧化锆桩和全瓷冠修复所有残冠、残根,经3年的临床跟踪,观察其临床效果。结果:观察期间失访2例患者,因此只对剩余43件修复体进行复查,其中中切牙28例,侧切牙7例,尖牙8例。2例患牙在第6个月时出现牙龈炎。1例右上中切牙氧化锆桩核修复体在第12个月后出现I-II°松动,1例右上侧切牙桩核修复体在第18个月后松动脱落。24个月和30个月时分别有1例患牙出现根折。所有复诊患者在36个月的临床观察中均未见桩核折断、边缘着色和继发性根尖周炎,并且所有修复体均获得满意美观效果。结论:CAD/CAM一体化氧化锆桩具有良好的美学效果和生物相容性,近期临床效果满意。     

Adhesive restoration of anterior endodontically treated teeth: influence of post length on fracture strength

Objectives

This study aims to evaluate the fracture resistance of endodontically treated anterior teeth restored with crowns made of composite or ceramic and retained without the use of a post (endocrowns) or with posts of 5 mm (short) and 10 mm in length (long).

Material and methods

Forty-eight intact maxillary incisors were selected for the study. After endodontic treatment, the crowns were sectioned 2 mm coronally to the cementoenamel junction provided with a ferrule of 2 mm. The roots were randomly divided into six groups (n?=?8) according to the post length and type of coronary restoration. The crowns were fabricated with the chairside economical restoration of esthetic ceramics system. Group 1 was restored with a 10-mm glass fiber post, composite core, and a full-coverage ceramic crown (LPCer); group 2, with a 5-mm glass fiber post, composite core, and a full-coverage ceramic crown (SPCer); group 3, with a 10-mm glass fiber post, composite core, and a full-coverage composite crown (LPCpr); group 4, with a 5-mm glass fiber post, composite core, and a full-coverage composite crown (SPCpr); and groups 5 (EndoCer) and 6 (EndoCpr) were restored with ceramic and composite endocrowns, respectively. The teeth were then thermomechanically loaded in a chewing machine. After fatigue, the specimens were loaded to fracture. Data were analyzed with ANOVA and chi-square test. Mode of failure was defined as repairable or non-repairable.

Results

Presence of post, post length, and crown material had no significant effect on the fracture resistance. Groups restored with endocrowns presented a higher number of repairable fractures in respect to the other groups.

Conclusions

Presence of a post had no effect on the restorations’ fracture strength.

Clinical relevance

Although this in vitro study has some limitations in respect to its clinical relevance, the restoration of largely destroyed anterior teeth with the use of an endocrown or a short glass fiber post might have advantages over a large glass fiber post.     

Influence of previous restoration of the tooth on prognosis of crowns with dowels

Due to extensive loss of tooth substance the restoration of endodontically treated tooth requires intracanal dowels to give an efficient strength for the crown. The aim of our study was to investigate whether the previous type of restoration of the tooth, i.e. composite restoration with screw post versus one-piece dowel crown, has an effect on the prognosis of crowns with dowels. The material consisted of 111 single crowns and as a previous restoration there were 83 composite restorations with screw posts and 28 one-piece dowel crowns. The mean follow-up time was 78 months (range 6--163 months). The cumulative survival was 87% for one-piece dowel crowns and 84% for composite resins with screw posts. There were six root fractures, four losses of cement retention and one tooth extraction due to caries in crowns with previous composite resin with screw posts. In one-piece dowel crowns as a previous restoration there were two root fractures and one tooth extraction for periodontal reasons. In conclusion, it seems that the previous restoration has no marked effect on the prognosis of crowns with dowels when studying a composite resin restoration with screw post and a one-piece dowel crown.     

前牙龈下残根正畸牵引后冠修复的临床疗效观察

目的探讨前牙龈下残根经正畸牵引后冠修复的临床疗效。方法断面位于龈下1～3mm的前牙残根40颗,行完善根管治疗后正畸牵引,粘接纤维桩,计算机辅助设计与制作（computer-aideddesign/computer-aidedmanufacture,CAD/CAM）全冠。正畸牵引前、后摄X线片,测量残根断缘距牙槽嵴顶的距离;用扩大针标记并测量残根断缘距龈缘的距离;计算牵引距离。冠修复后3、6、24个月复查,评价疗效。结果正畸牵引龈下残根6～8周后,所有残根断缘均超出龈缘。40颗残根断缘距龈缘的平均距离1.15mm;残根断缘距牙槽嵴顶的平均距离3.85mm;平均牵引距离2.59mm。CAD/CAM全冠修复后随访24个月,40颗患牙稳固且牙龈健康,美观效果好,牵引后位置稳定。结论前牙残根经正畸牵引后行冠修复可达到美容和功能兼顾的较好效果。     

上颌前牙三种不同方法根管预备后剩余根管壁厚度的研究

目的探讨上颌前牙根管预备后距根尖4mm处根管壁的最小厚度,为临床预备桩腔末端的宽度提供理论依据。方法离体直单根管上前牙60个,随机分为3组（n=20）进行根管预备,A组：不锈钢根管锉常规法;B组：G型钻根管冠部预处理＋不锈钢根管锉常规法;C组：手用ProTaper镍钛根管锉冠向下法。所有牙齿用金刚砂片分别在距根尖4mm处和釉牙骨质界处截断牙根,截断面垂直于根管。用游标卡尺测量断面根管近中壁、远中壁最薄处厚度。结果三种方法根管预备后距根尖4mm处和釉牙骨质界处剩余根管壁厚度均数都大于1mm。釉牙骨质界处与距根尖4mm处剩余根管壁厚度之间行直线相关分析,只有B组釉牙骨质界处与距根尖4mm处远中壁剩余根管壁厚度之间存在线性相关,其它组之间均不存在线性相关。结论对于大多数病例,经三种方法根管预备后,推荐使用3#P型钻预备上颌前牙桩腔末端。     

前牙龈下残根残冠的修复

目的 探讨保留位于龈下的残根、残冠，进行铸造桩核加金属烤瓷冠修复的方法。方法 对11例（12个牙）根面位于龈下3mm左右的残根、残冠，经根管治疗后，采用烤瓷熔附金属全冠或桩冠修复。结果 经1－4年的临床观察，修复冠稳固，根周无明显炎症。结论 根面位于龈下3mm左右的残根、残冠可予以保留、进行桩冠修复，恢复患者的正常咀嚼功能。